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The Outcomes of Revisional One Anastomosis Gastric Bypass Versus Revisional Roux-en-Y Gastric Bypass After Primary Restrictive Procedures:A Prospective Nonrandomized Comparative Study

Background
Failed restrictive procedures are usually managed with conversion to another bariatric procedure.
Our aim was to evaluate one -anastomosis gastric bypass (OAGB) as a revisional option for failed restrictive procedures. In addition, we compare the outcomes of OAGB versus Roux-en-Y gastric bypass as a revisional bariatric procedures.

Material and Methods
The current series is a prospective study, from May 2009 to December 2016. A total of 348 patients with failed restrictive bariatric operations underwent laparoscopic revisional gastric bypass.
Revisional OAGB was performed in 243 patients and revisional Roux-en-Y gastric bypass in 105 patients. The demographic data and outcomes were studied by our multidisciplinary team.

Result
By the end of the study, the mean age was 39.3 – 10.3 years with body mass index of 37.5 – 9.2 kg/m2
At 2-year follow-up, the overall intractable reflux (Symptom-Severity score questionnaire >4) was significantly higher after revisional OAGB (21.4%). The reflux with scoring ‡4 was significantly higher in the vertical band gastroplasty than laparoscopic adjustable gastric band and laparoscopic gastric sleeve (25.2%, 16.9%, and 14.3%, respectively).

Conclusion
Although laparoscopic revisional OAGB is a feasible and safe option after failed restrictive procedures, it has a higher chance of reflux in long-term follow-up.

Authors
Ahmed Aosmali
King's College Hospital NHS Trust, LONDON, United Kingdom

Osama Taha
Assuite University, Assuite, Egypt

Momen abdelglil
Faculty of Medicine, Mansura Univeristy, Mansura, Egypt

Mahmoud ABDELAAL
Assuite University, Assuite, Egypt

Mahmoud Nafie
King's College Hospital NHS Trust, LONDON, United Kingdom

Rodaina Radwan
Faculty of Medicine, Ain ShamsUniveristy, Cairo, Egypt